Cannabis-based medicines showed subjective improvement in MS spasticity despite mixed results on clinical scales

A review found cannabis-based medicinal extracts (CBMEs) improved patient-reported spasticity in multiple sclerosis, though objective measures like the Ashworth scale often showed no significant effect.

Smith, Paul F·Therapeutics and clinical risk management·2010·Moderate EvidenceReview
RTHC-00453ReviewModerate Evidence2010RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

The review examined clinical trial evidence for cannabis-based medicinal extracts (CBMEs) in treating spasticity associated with multiple sclerosis (MS).

Patients consistently reported subjective improvement in spasticity when using CBMEs. However, objective measurements using the Ashworth scale (a clinical rating of muscle resistance) generally showed no significant effect. The authors noted that the validity of the Ashworth scale itself had been questioned.

Side effects were generally mild, including dry mouth, dizziness, drowsiness, nausea, and intoxication. Most clinical trials ran for only months, and long-term safety data were limited.

The review flagged particular caution for adolescents, people predisposed to psychosis, and pregnant women.

Key Numbers

Mild adverse effects reported: dry mouth, dizziness, somnolence, nausea, intoxication. Most trials ran for months. Ashworth scale generally showed no significant effect despite patient-reported improvement.

How They Did This

Narrative review of clinical trial data examining cannabis-based medicinal extracts for MS-related spasticity, published in Therapeutics and Clinical Risk Management.

Why This Research Matters

The disconnect between patient-reported improvement and objective clinical measures highlighted a challenge in evaluating cannabis-based medicines and raised questions about which outcome measures best capture treatment benefits.

The Bigger Picture

This review contributed to the evidence base that led to cannabis-based medicines being approved for MS spasticity in several countries, despite the measurement challenges.

What This Study Doesn't Tell Us

Narrative review without systematic methodology. Reliance on subjective outcomes. Limited long-term safety data. The Ashworth scale limitations make it difficult to assess true objective efficacy.

Questions This Raises

  • ?What is the best way to objectively measure spasticity improvement?
  • ?Would longer-term trials reveal additional benefits or risks of CBMEs?

Trust & Context

Key Stat:
Subjective improvement reported despite mixed objective measurements
Evidence Grade:
Narrative review synthesizing clinical trial data with acknowledged limitations in outcome measurement.
Study Age:
Published in 2010. Nabiximols (Sativex) has since been approved in multiple countries for MS spasticity.
Original Title:
New approaches in the management of spasticity in multiple sclerosis patients: role of cannabinoids.
Published In:
Therapeutics and clinical risk management, 6, 59-63 (2010)
Authors:
Smith, Paul F(5)
Database ID:
RTHC-00453

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

Do cannabis medicines help with MS muscle stiffness?

Patients consistently reported improvement in spasticity, but clinical rating scales often showed no significant objective change. The mismatch may reflect limitations of the measurement tools rather than lack of true benefit.

What are the side effects of cannabis-based MS treatments?

The review found mostly mild side effects: dry mouth, dizziness, drowsiness, nausea, and intoxication. Long-term safety data beyond a few months were limited.

Read More on RethinkTHC

Cite This Study

RTHC-00453·https://rethinkthc.com/research/RTHC-00453

APA

Smith, Paul F. (2010). New approaches in the management of spasticity in multiple sclerosis patients: role of cannabinoids.. Therapeutics and clinical risk management, 6, 59-63.

MLA

Smith, Paul F. "New approaches in the management of spasticity in multiple sclerosis patients: role of cannabinoids.." Therapeutics and clinical risk management, 2010.

RethinkTHC

RethinkTHC Research Database. "New approaches in the management of spasticity in multiple s..." RTHC-00453. Retrieved from https://rethinkthc.com/research/smith-2010-new-approaches-in-the

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.